Oregon Psilocybin Services

1. Introduction

Version followed: Oregon Administrative Rules chapter 333, division 333 (OAR 333-333) as amended by Oregon Psilocybin Services (OPS) under Permanent Administrative Order PH 21-2025 (filed 24 October 2025, in force from 1 January 2026). Read with the OPS facilitator page; the Facilitator Scope of Practice, Facilitator License (updated December 2024), Health and Safety (May 2025) and Dual Licensure (HB 2387) fact sheets; the OHA Interpreter or Client Support Person Plan form (updated 1 January 2025) and Client Safety and Support Plan form (updated 21 February 2025); and the November 2025 rule letter to facilitators. A notice filed in late August 2026 proposed amendments to 67 rules; OHA has since announced that it will not file final rules from that process, and a new rulemaking with a planned effective date of 15 January 2027 is under way [source: OHA Psilocybin Administrative Rules page; OPS 2026 Annual Rulemaking, Part One page]. Sources include OHA documents on the support-person and safety-plan content, the dual-licensure rules, the training-hour figures and the 2026 proposal; and the rule texts on support persons (OAR 333-333-5070), safety plans (5080), facilitator conduct and supportive touch (5120), and group sessions (5020, 5230) as published by Cornell LII (amended effective 1 January 2025). PH 21-2025 left 5070 and 5080 unchanged but lists 5020, 5120 and 5230 among the rules it amended [source: PH 21-2025 tracked changes]; the detail of those three amendments is not reflected here [uncertain: check the current OAR text].

What it is. Oregon Psilocybin Services is not a psychotherapy. It is a state-regulated adult-access programme run by the Oregon Health Authority (OHA) under ORS 475A, which Oregon voters passed in November 2020 (Measure 109). OHA licenses manufacturers, testing laboratories, service centres and facilitators. Adults aged 21 or over may receive "psilocybin services" in three parts: a preparation session, an administration session at a licensed service centre, and optional integration sessions. No diagnosis or referral from a clinician is needed. [source: OPS 2025 Year-End Data Summary; Facilitator License fact sheet; OAR 333-333-4520 as quoted in the 2025 redline] The first service centre (in Eugene) was licensed in May 2023 and opened in June 2023 [source: OPB, 26 Aug 2023].

Legal status (as of the sources' dates, 2025–2026). Psilocybin remains a federal Schedule I substance and is not FDA-approved. Clients must acknowledge in the OPS informed consent that federal prohibitions apply whatever state law says. [source: OAR 333-333-5040] Within Oregon, services are lawful only through licensed service centres, licensed facilitators and tested products. Clients may not bring product onto or take it off the premises. [source: OAR 333-333-4480 in 2025 redline] Many Oregon cities and counties have voted to ban psilocybin businesses locally: one report counts 25 counties and 26 towns in the November 2022 election, and 16 of 17 local ban measures passed in November 2024 [source: KLCC, 8 Nov 2024]. Counts differ between reports, so check the rules where the client lives and where the centre is [uncertain: no official OHA list consulted]. Colorado runs a separate regulated natural-medicine programme [uncertain: not sourced here]. This guide covers Oregon only.

Core idea of how change happens. OPS makes no therapeutic claim. Its informed consent presents possible benefits for depression, anxiety, trauma and substance use as uncertain, and states that services are not medical diagnosis, referral or clinical treatment. [source: OAR 333-333-5040] The programme's model is client-led. Clients choose to take part, choose their facilitator and product, and are supported by a non-directive facilitator who does not interpret, diagnose or steer the experience. Any meaning-making happens through the client's own process and optional integration. [source: Facilitator Scope of Practice fact sheet] Since 1 January 2026 (HB 2387), a licensed facilitator who also holds a licence from one of seven Oregon boards may, after notifying OHA, provide health or behavioural-health care while conducting preparation and integration sessions, but not during administration sessions. The seven boards are: Licensed Professional Counselors and Therapists, Naturopathic Medicine, Psychology, the Oregon Medical Board, the State Board of Nursing, Licensed Social Workers, and Pharmacy. HB 2387 also bars these boards from disciplining licensees for lawfully providing psilocybin services. [source: Dual Licensure HB 2387 fact sheet; OPS facilitator page; Rule Letter November 2025]

Scale. In 2025 OPS reported 377 facilitator licences, 25 service centre licences, 5,935 clients, 4,628 individual and 747 group administration sessions, 38 reported adverse reactions including post-session reactions, and 13 emergency-service contacts. [source: 2025 Year-End Data Summary]

Role of a psychotherapist outside the programme. If you are not an OPS facilitator, you cannot provide or attend administration as a clinician unless the client consents to you being present as a support person (see 4.12). Your role is assessment, informed discussion, liaison with the facilitator (with written authorisation), supporting the client's safety planning, and integration work in your own therapy. [source: OAR 333-333-5000; 5050] [synthesis for the role framing]

2. Framework

OPS defines a three-part sequence. Session numbers are minimums set by rule, not a treatment course. [source: OAR 333-333-5000; 5250; Scope of Practice fact sheet]

Phase 0: Facilitator and service-centre selection (client-led).

Goal: the client chooses a licensed facilitator and service centre suited to their needs, language, culture and preferred format (individual or group).
The client may choose their facilitator. They must be offered another one if the facilitator has supervisory or evaluative authority over them. The client must be able to approve and meet every facilitator before receiving services from them. [source: OAR 333-333-5040; 5000]
Facilitators and service centres may decline a client for any reason and may refer elsewhere. [source: Client Bill of Rights in OAR 333-333-4520; Scope of Practice fact sheet]

Phase 1: Preparation (one or more sessions).

Format: private and individual, in person or by video. It may be split across several meetings. Only the client, the facilitators and any client support persons who will attend administration may be present. Practicum supervisors, lead educators and students may attend only with the client's prior written consent. [source: OAR 333-333-5000]
Timing: at least 24 hours and no more than 90 days before the first administration session with that facilitator. [source: OAR 333-333-5000]
Goals: intake and eligibility (Client Information Form), informed consent, Client Bill of Rights, fee and price documentation, product potency information, the relevant parts of the centre's emergency plan, the firearms and weapons policy, safety and support plan, transportation plan, accessibility plans, all written consents, intentions and expectations, and how to verify a licence and complain to OHA. [source: OAR 333-333-5000]
Criteria to move on: all forms and written consents signed and complete. No exclusionary answer on the Client Information Form (lithium use in the past 30 days, current thoughts of harming self or others, or active psychosis). An accessible or translated form provided if the client needed one. A transportation plan that does not approve the client to drive or ride afterwards. The facilitator judges they can serve the client safely. [source: OAR 333-333-5000; 5050; 5040]
Within 12 months at the same centre, no new preparation session is needed. The facilitator must confirm before each administration session that the Client Information Form is still accurate. If it is not, the facilitator holds another preparation session and updates the form. [source: OAR 333-333-5000]

Phase 2: Administration session (one per occasion, at a licensed service centre).

Format: individual or group. Group administration sessions are governed by OAR 333-333-5230 (and group preparation by 5020). The number of facilitators required depends on the amount each client will consume, including any secondary dose; where amounts differ, the largest sets the ratio for the whole group. Ratios tighten as amounts rise, from one facilitator per 25 clients at the lowest tier to one per 2 at the highest (amounts not given here). A group may have no more than 25 clients or the room's maximum occupancy, whichever is smaller. [source: OAR 333-333-5230, as amended effective 1 January 2025; Health and Safety fact sheet, May 2025] [uncertain whether PH 21-2025 changed these figures] Facilitator presence and monitoring in administration sessions are governed by OAR 333-333-5200, which also caps a centre at 100 clients at any one time. [source: OAR 333-333-5200]
The facilitator is present throughout and non-directive. Facilitators may not handle, sell, administer or consume product while providing services. [source: Scope of Practice fact sheet]
Duration: rules set minimum session lengths that scale with the total amount consumed. Shorter minimums apply to some repeat sessions at the same centre. Amounts are not given here. Sessions running past 11:59 pm must be reported to OHA by 4:00 pm the next day. [source: OAR 333-333-5250]
Criteria to end: the minimum duration has passed, AND facilitator and client agree that continuing is not needed for the safety of the client and the public. The client then signs a release agreeing to end the session and follow the transportation plan. [source: OAR 333-333-5250]

Phase 3: Post-session contact and integration (optional for the client).

Within 72 hours the facilitator must attempt to contact the client. The contact offers information on integration sessions, peer support groups and community resources, reviews the safety and support plan, and records any after-effects. [source: OAR 333-333-5250; Health and Safety fact sheet]
Integration sessions are optional and have no set number. Facilitators may review the safety and support plan and offer resources, referrals or other integration options. Dual licensees may provide behavioural-health services in integration from 2026. [source: Scope of Practice fact sheet; OPS facilitator page]
Typical overall format: at least one preparation session, one administration session, one 72-hour contact, and zero or more integration sessions [synthesis from the rules above].

Who may be a facilitator. Aged 21 or over, with a high-school diploma or equivalent. Has completed an OPS-approved training programme (core training, practicum and the programme's exam). Has passed the OPS rules exam (75% pass mark) and a criminal background check, and has submitted a social equity plan. The licence lasts one year. From 2026, renewal requires four hours of continuing education. [source: Facilitator License fact sheet; OPS facilitator page; Notice of Proposed Rulemaking, Aug 2026] Training programmes must provide at least 128 hours of core training for applications and renewals received on or after 1 January 2025. The hours are split across nine areas. Four areas get 12 hours each: historical, traditional and contemporary practices; cultural equity; safety, ethics and responsibilities; and pharmacology, neuroscience and clinical research. Three get 16 hours each: core facilitation skills, preparation and orientation, and group facilitation. Administration gets 20 hours and integration 12. If training is not given in person, at least half of it must be live (synchronous) online learning. The practicum is at least 40 hours: at least 30 hours of observation or direct practice and at least 10 of consultation. Up to four hours of credit may come from taking part as a client at a practicum site. After 1 January 2026, all practicum must take place at a practicum site. Students may not provide psilocybin services. [source: OAR 333-333-3050; 3070, as shown in the 333-333 proposed text 9.1.2026; Notice of Proposed Rulemaking, Aug 2026] The effective dates in the rule text suggest these minimums are already in force, and the 2026 proposal restates them [inference].

3. Guiding principles

Client autonomy and voluntariness. Taking part is the client's choice, and the client may decline to consume at any point. Practically: never pressure attendance, product choice or continuation, and check consent again before administration. [source: OAR 333-333-5040; Client Bill of Rights]
Non-directive facilitation. During administration the facilitator does not interpret, diagnose or guide outcomes, and lets the client explore. Practically: offer presence, reassurance and safety, not meaning. [source: Scope of Practice fact sheet]
Consistent demeanour. Facilitators keep a client-centred approach and a steady manner. Practically: stay calm and predictable, especially when the client is distressed. [source: Health and Safety fact sheet]
Not medical or clinical treatment. Services are not diagnosis, referral or clinical treatment, except health services that dual licensees provide in preparation and integration from 2026. Practically: do not present an OPS session as therapy, and keep your own clinical work clearly separate. [source: OAR 333-333-5040; Rule Letter November 2025]
Scope of practice and the right to decline or refer. Facilitators work within their expertise and may decline or refer. Practically: match the client to a facilitator with relevant experience, and refer out when needs exceed that. [source: Scope of Practice fact sheet; Facilitator License fact sheet]
No other licence during administration. Dual licensees may not practise their other profession during administration sessions. Practically: a psychotherapist-facilitator does not do therapy in the administration room. [source: Scope of Practice fact sheet; Facilitator License fact sheet]
Prior written consent for touch and enhancements. Supportive touch needs prior written consent and a prior discussion of what touch is acceptable. Music and other sensory enhancements need prior consent, which the client can withdraw at any time. Practically: agree on touch in preparation, and if in doubt, do not touch. [source: Scope of Practice fact sheet; OAR 333-333-5040]
Safety planning before experience. Every client has a safety and support plan, a transportation plan and the relevant parts of the emergency plan before administration. Practically: risks and supports are named in advance, not improvised. [source: OAR 333-333-5000; Health and Safety fact sheet]
Continuous presence until safe. Clients have the right to be monitored by a licensed facilitator for the full duration until it is safe to leave, except in an emergency. Practically: no unsupervised gaps beyond short restroom breaks that were disclosed in advance. [source: Client Bill of Rights in 2025 redline; OAR 333-333-5040]
Confidentiality with legal exceptions. Identifying information is shared only with written consent or under ORS 475A.450's exceptions. These are: the client's own legal action or complaint, intent to commit a harmful crime, signs a minor may be a victim, and OHA investigations. Practically: get written authorisation before you liaise with a facilitator. [source: OAR 333-333-5040; Scope of Practice fact sheet]
Cultural and linguistic responsiveness and equity. Facilitators disclose culturally and linguistically responsive services and make their social equity plans available. Translated or accessible forms are mandatory on request. Practically: ask about language, culture and access needs early. [source: Scope of Practice fact sheet; OAR 333-333-5050]
Transparency about money and conflicts. Fees, refunds, cancellation fees and product prices must be disclosed before any payment, and facilitator conflicts of interest must be disclosed. Practically: no surprise costs and no undisclosed financial ties. [source: OAR 333-333-5000; 4520]
Accountability. Clients are told how to verify licences and complain to OHA. Facilitators must report misconduct that harms a client and may be mandatory abuse reporters. Practically: make the complaint route easy to find. [source: OAR 333-333-5040; 5000]

4. Intervention inventory

This is a regulated access programme, so the "interventions" are the procedures the rules require. Each is marked as either a facilitator task within OPS or a task for a psychotherapist working alongside OPS. The rules set what must happen. The step-by-step sequencing and all example wording are illustrative [synthesis] unless cited. No product amounts, potency figures or administration details are given anywhere in this guide.

4.1 Pre-referral assessment and education (outside psychotherapist)

Purpose / when: when a client in your care asks about OPS. The aim is to help them decide with full information and to spot exclusions and risks early. [synthesis, built on the OPS eligibility rules in OAR 333-333-5050]
Steps:
1. Explain what OPS is and is not. It is state-licensed and lawful in Oregon, still federally illegal, not FDA-approved, and not clinical treatment. Benefits are uncertain. [source: OAR 333-333-5040]
2. Screen for the rule's hard exclusions: lithium in the last 30 days, current thoughts of harming self or others, active psychosis. If any is present, say plainly that the client cannot take part at present. [source: OAR 333-333-5050]
3. Review the conditions where the rules expect medical advice: current treatment for a health condition, a history of harm to self or others, medications, pregnancy or breastfeeding (risks unknown), and fungi allergy. Encourage the client to talk to their prescriber, pharmacist or physician. Do not advise stopping or changing medication yourself unless that is within your licence. [source: OAR 333-333-5050] [synthesis on scope]
4. Do your own clinical risk assessment: suicide risk using standard structured practice, personal or family history of psychosis or bipolar disorder, current trauma symptom load and stability, substance use, and supports at home. Do not treat the OPS form as a substitute for it. [synthesis]
5. Discuss the set of questions a client may want to ask facilitators (see 4.2).
6. Document the discussion and any recommendation you made, including any recommendation not to proceed now. [synthesis]
Example language (illustrative): "This is legal in Oregon through licensed centres, but it isn't treatment and it is still illegal federally. Let's look at whether anything would rule it out for you right now, and what your doctor needs to weigh in on."
Watch for: pressure from partners or others, crisis-driven urgency, expecting a cure, a hidden plan to stop psychiatric medication, recent suicidality. Signs it is working: the client can restate the risks and the exclusion criteria and has a plan to consult their prescriber. [synthesis]

4.2 Choosing and verifying a facilitator and service centre

Purpose / when: before preparation. The client chooses a facilitator whose experience, format and cultural fit match their needs. [source: OAR 333-333-5040; Scope of Practice fact sheet]
Steps:
1. The client verifies the facilitator's and the centre's licence status. OHA's verification and complaint process must be shared in preparation. [source: OAR 333-333-5000]
2. The client asks about individual versus group format, any culturally or linguistically responsive services, and the facilitator's social equity plan. [source: Scope of Practice fact sheet]
3. The client asks whether the facilitator is a dual licensee who will provide health or behavioural-health services in preparation and integration. Such facilitators must notify the client before doing so. [source: Rule Letter November 2025]
4. The client meets and approves every facilitator who will serve them. If different facilitators will cover different phases, this needs written consent. [source: OAR 333-333-5000]
5. The client asks about fees, refunds and cancellation fees. These must be disclosed before any payment. [source: OAR 333-333-5000]
Example language (illustrative): "It's worth asking each facilitator how they handle distress, what touch they do and don't offer, and whether they offer integration afterwards."
Watch for: a facilitator who has supervisory or evaluative power over the client (the client must be offered another), therapeutic or cure claims, discounting or free product (prohibited for centres). [source: OAR 333-333-5040; 4480]

4.3 Client Information Form review and eligibility decision (facilitator)

Purpose / when: in preparation, before any administration session. Its job is to identify exclusions and the plans the client will need. [source: OAR 333-333-5050]
Steps:
1. Provide the OHA form, translated or in an accessible format if requested. If you cannot provide one, the session cannot go ahead. Use the version updated for 2026. [source: OAR 333-333-5050; OPS facilitator page]
2. Go through the yes/no items (medication, health treatment, allergies, accessibility, harm to self or others, psychosis, pregnancy or breastfeeding) and the narrative items (medical and mental-health history including trauma, triggers, substance use, past psychedelic experience, life circumstances). Do not reproduce the form's wording elsewhere. [source: OAR 333-333-5050]
3. Apply the consequences the rule attaches to each answer:
  - lithium use in the past 30 days, current thoughts of harm, or active psychosis: no administration session;
  - current treatment or a history of harm: encourage consultation with a health provider;
  - fungi allergy: encourage an alternative product type;
  - medications: encourage consulting a pharmacist or provider; any medication needed during the session must be self-administered or given by a named support person;
  - pregnancy or breastfeeding: tell the client the risks are unknown;
  - interpreter, assistance, device or mobility needs: make the written plans these require (see 4.8);
  - other concerns: make a written plan for reasonable accommodations. [source: OAR 333-333-5050]
4. Decide whether you can serve the client safely. Decline or refer if not. [source: Scope of Practice fact sheet; Client Bill of Rights]
5. Before each later administration session within 12 months, reconfirm the form. Hold a new preparation session if anything has changed. [source: OAR 333-333-5000]
Example language (illustrative): "Some answers mean we can't go ahead right now, and some mean I'll ask you to talk to your doctor first. None of this is a judgement about you."
Watch for: minimising answers to get access, recent medication changes, and answers that change between preparation and the session day. [synthesis]

4.4 Informed consent review (facilitator)

Purpose / when: in preparation. The signed copy is required before administration. [source: OAR 333-333-5040]
Steps:
1. Give the OHA informed consent document. The client may ask for it in advance. Provide a translated or accessible version on request. [source: OAR 333-333-5040; 5000]
2. Go through each statement and have the client initial it. The statements cover:
  - the Bill of Rights;
  - that services are not treatment;
  - federal status;
  - uncertain benefits;
  - common, usually temporary side effects (nausea, headache, anxiety, confusion, raised heart rate and blood pressure, paranoia, recovered memories);
  - interaction uncertainty;
  - pregnancy and allergy cautions;
  - unknown risks of higher amounts and of repeated use;
  - unpredictable onset;
  - group effects;
  - touch only with prior written consent;
  - mandatory-reporter status;
  - misconduct reporting;
  - restroom breaks;
  - transportation;
  - leaving mid-session being strongly discouraged;
  - emergency contact;
  - the client paying emergency costs;
  - data and privacy;
  - voluntariness;
  - cancellation fees;
  - choice of facilitator;
  - the complaint route. [source: OAR 333-333-5040]
3. Disclose your own mandatory-reporter obligations. [source: OAR 333-333-5040]
4. Invite questions and check understanding. Collect the signed form. [source: OAR 333-333-5040]
Example language (illustrative): "You can decide not to take anything at any point, even on the day. Leaving once a session has started is strongly discouraged, which is why we plan your ride now."
Watch for: signing without reading, and expectations of guaranteed benefit. Signs it is working: the client can explain the federal-law risk and the leaving rule in their own words. [synthesis]

4.5 Client Bill of Rights, fees and price disclosure (facilitator)

Purpose / when: in preparation, before any money is collected. [source: OAR 333-333-5000]
Steps:
1. Review the Bill of Rights (revised for 2026). It covers the right to choose or change facilitator, to be monitored until it is safe to leave, to have a licensed facilitator for the full duration, and to change consent before administration. Note that the right to prior notice of centre representatives in the administration area was removed in 2026. [source: OAR 333-333-4520 in 2025 redline; OPS facilitator page]
2. Give fee documentation, prepared with the centre. It states who receives fees, the refund policy and any added fees. [source: OAR 333-333-5000]
3. Give product price documentation, with prices listed separately from taxes. [source: OAR 333-333-5000]
4. Explain that unused product is returned or destroyed and refunded. [source: Health and Safety fact sheet]
Example language (illustrative): "Here is exactly what you'll pay and to whom, and what happens if you cancel."
Watch for: financial strain driving decisions, and confusion about who is the provider. [synthesis]

4.6 Product information discussion (facilitator only)

Purpose / when: in preparation. Facilitators help clients choose the product they plan to buy, using the OPS Product Potency Information Document. Discussing it is mandatory from 2026. [source: Scope of Practice fact sheet; Rule Letter November 2025]
Steps (framework only):
1. Review the product information for any products the client may consume. [source: OAR 333-333-5000]
2. Explain that legal limits exist on amounts, that session length and group staffing depend on the amount, and that potency varies between mushrooms. [source: OAR 333-333-5250; 5040; Health and Safety fact sheet]
3. Obtain written consent for any additional product after the session starts. This consent states the maximum the client agrees to, within a regulatory ceiling. [source: OAR 333-333-5000]
4. Where a client plans services across several days, the 2026 rules require an agreed plan with the facilitator. [source: Rule Letter November 2025]
For the outside psychotherapist: do not advise on product choice or amount. Refer those questions to the facilitator, and refer medication-interaction questions to a pharmacist or prescriber. [synthesis]
Watch for: a client who wants the "strongest" option to force a breakthrough. Explore the motive in therapy. [synthesis]

4.7 Safety and support plan (facilitator; outside therapist may contribute)

Purpose / when: completed in preparation for every client. It identifies personal risks and available resources, and it is reviewed again at the 72-hour contact and in integration. [source: OAR 333-333-5000; Health and Safety fact sheet; Scope of Practice fact sheet]
Steps:
1. Use the OHA Client Safety and Support Plan form (updated 1 January 2025). [source: OPS facilitator page]
2. Complete the plan together in a preparation session, before any administration session; client and facilitator both sign and date it. The OHA form has five parts: client name and date; an emergency contact (name and phone) for medical or other emergencies; a client concerns and support-planning section covering the client's specific risks and challenges, the resources available, their existing support network and suitable outside resources; any culturally and linguistically responsive services the client asked for; and both signatures. The plan cannot be changed during the administration session. [source: OHA Client Safety and Support Plan form, Spanish version updated 21 Feb 2025; Health and Safety fact sheet] The rule itself requires the facilitator to draft the plan with each client, identifying the client's particular risks and challenges and the resources to meet them (including their support network and outside resources), to list an emergency contact, and not to alter the plan during an administration session; records are kept at the service centre or on a permitted cloud platform. [source: OAR 333-333-5080; preparation timing from OAR 333-333-5000]
3. Where the client asked for culturally and linguistically responsive services, describe them in the plan. [source: 2025 redline, 5000(7)]
4. Outside therapist: with consent, offer to be named as a post-session support and agree on how the client can reach you in the days after. Include crisis lines and a plan for any post-session distress. [synthesis]
Example language (illustrative): "If the days afterwards feel shaky, who will you call first, and what will you do if you can't reach them?"
Watch for: a plan with no real people in it, or a client living alone with a high trauma load. Strengthen supports or delay. [synthesis]

4.8 Transportation, accessibility, interpreter and support-person plans (facilitator)

Purpose / when: in preparation, so the client gets home safely and access needs are met. [source: OAR 333-333-5000; 5050]
Steps:
1. Complete the transportation plan. It may not approve the client to drive or ride a bicycle or other vehicle afterwards. [source: OAR 333-333-5000]
2. Make whatever written plans the client's needs require:
  - medication and medical or assistive device plan;
  - emergency exit plan for clients who use mobility devices;
  - identified support person for communication devices;
  - interpreter (in person or virtual). [source: OAR 333-333-5050]
3. Get written consent for any interpreter or client support person in the administration area, using the OHA Interpreter or Client Support Person Plan (one form per person). The client and facilitator meet the interpreter or support person before administration and complete the form together in preparation. The facilitator gives that person the Client Bill of Rights and answers their questions. The plan records who the person is, what help they will give and why, any medications or devices, and whether they stay for the whole session or are on call. The support person and the client both sign. [source: Interpreter or Client Support Person Plan form, updated 1 Jan 2025; OAR 333-333-5070] The form lists these purposes: help with medication, medical devices, catheter, ostomy or toileting needs, walking or transfers, and communication or listening devices; help in consuming the product; and observing, when the client asks and the facilitator and centre agree. A support person may do only the tasks in the plan and may touch the client only as those tasks need (observers: hugs, or hands on the client's hands, feet or shoulders). They sign that they will stay within their stated purpose, not interfere or take part in the session, and keep the client's participation confidential. They must follow the facilitator's reasonable directions; an observer may be asked to leave at any time. A facilitator or centre representative may not act as support person in a session they are facilitating or representing, and centres and facilitators may not pay or provide support persons or require a client to use a particular one. Practicum students and supervisors may not act as support persons. [source: OAR 333-333-5070; same form; 333-333 proposed text 9.1.2026; Notice of Proposed Rulemaking, Aug 2026] Neither the form nor the rule says whether a support person may consume product [uncertain].
4. Review the relevant parts of the centre's emergency plan and its firearms and weapons policy. [source: OAR 333-333-5000]
5. For outdoor sessions, discuss allergies and sun sensitivity. [source: OAR 333-333-5000]
Example language (illustrative): "Who will collect you, and what's the backup if they can't?"
Watch for: vague ride arrangements. The facilitator may call emergency services if a failure to follow the plan creates a safety risk. [source: OAR 333-333-5040]

4.9 Other written consents (facilitator)

Purpose / when: in preparation, for each special circumstance. [source: OAR 333-333-5000]
Steps: obtain prior written consent, using the OHA forms, for each of these that applies:
- group participation;
- supportive touch;
- training practicum involvement (with a chance to meet students and instructors);
- video or audio recording (from everyone present);
- an interpreter or support person;
- sharing identifiable data;
- different facilitators across phases;
- additional product;
- the de-identified data disclosure and opt-out.
Also offer the chance to withhold SB 303 data from what goes to OHA. From 2026, consent is no longer needed for licensee representatives to be present, and group clients no longer have to meet other participants first. [source: OAR 333-333-5000; Scope of Practice fact sheet; Rule Letter November 2025]
Example language (illustrative): "Each of these is a separate yes or no, and you can say no to any of them."
Watch for: consent fatigue. Space the consents across preparation meetings if needed, since preparation may be split. [synthesis; OAR 333-333-5000]

4.10 Intentions, expectations and set-and-setting discussion (facilitator; outside therapist)

Purpose / when: in preparation. The rule requires discussing internal and external factors that could affect the experience, including intentions and expectations. [source: OAR 333-333-5000]
Steps:
1. Ask about the client's reasons, hopes, fears and expectations. [source: OAR 333-333-5000]
2. Discuss external factors: the room, music or other sensory enhancements (which need consent), group or individual format, who will be present, and life stressors in the coming weeks. [source: OAR 333-333-5000; Scope of Practice fact sheet]
3. Explain the non-directive stance: the facilitator will not interpret or guide. [source: Scope of Practice fact sheet]
4. Outside therapist: help the client turn vague hopes into realistic, open intentions, and talk through difficult possibilities such as fear or recovered memories, which the consent names as possible. [synthesis; side-effect list from OAR 333-333-5040]
Example language (illustrative): "What would you want to remember to bring with you into the session, and what would you want to do if something frightening came up?"
Watch for: rigid outcome demands, plans to confront someone straight after the session, or trauma material the client has never processed. [synthesis]

4.11 Non-directive presence during administration (facilitator)

Purpose / when: throughout the administration session, so the client can explore safely. [source: Scope of Practice fact sheet]
Steps:
1. Before starting, confirm the forms are complete and the Client Information Form is still accurate. A facilitator new to this client must review all the records first. [source: OAR 333-333-5000]
2. Stay present throughout, apart from short restroom breaks disclosed in advance. Do not practise any other licence, and do not handle or consume product. [source: Scope of Practice fact sheet; OAR 333-333-5040]
3. Keep a consistent, client-centred manner. Do not interpret, diagnose or steer. [source: Scope of Practice fact sheet; Health and Safety fact sheet]
4. Respond to discomfort or distress (see 4.13). [source: Scope of Practice fact sheet]
5. Record the start and end times and any adverse reactions. [source: OAR 333-333-5100; 5250]
Example language (illustrative): "I'm right here. You're safe. You can let whatever is happening be there." (presence, no interpretation)
Watch for: your own urge to explain or coach. Under the rules, interpretation belongs, if anywhere, in integration. [synthesis]

4.12 Supportive touch and sensory enhancements (facilitator)

Purpose / when: only when the client agreed in advance, in writing, to touch for comfort or grounding during administration. Music and other sensory enhancements likewise need prior consent. [source: Scope of Practice fact sheet; OAR 333-333-5000; 5040]
Steps:
1. In preparation, discuss what kinds of supportive touch the client would accept, if any. Record it on the OHA Client Consent for Use of Supportive Touch form. [source: OAR 333-333-5040; Scope of Practice fact sheet]
2. In the session, offer only touch that was agreed. Check in before touching, and stop at once if the client withdraws consent. The client can withdraw consent to enhancements at any time. [source: Scope of Practice fact sheet] The preparation rule requires prior written consent to any supportive touch during administration. [source: OAR 333-333-5000] Under the facilitator-conduct rule, a facilitator may give supportive touch only when the client requests it and has given prior written consent, and supportive touch is limited to hugs or placing hands on the client's hands, feet or shoulders; the facilitator may not use, or allow anyone else to use, any other form of touch during an administration session. Romantic relationships, sexual contact and sexual intimacy with a client are prohibited during services and for one year afterwards. [source: OAR 333-333-5120, as amended effective 1 January 2025] Never go beyond what the client agreed in writing, never expand the agreement during the session, and check verbally before each touch. Touch is never sexual. [synthesis]
3. In groups, clients may not touch each other, except permitted supportive touch (hugs or hands on hands, feet or shoulders) with prior written consent. The room must let everyone take part without touching or coming into close contact, with at least 25 square feet per person, and must let a facilitator monitor every client. [source: OAR 333-333-5230; OAR 333-333-5120]
Example language (illustrative): "Earlier you said a hand on your shoulder might help. Would that be okay right now?"
Watch for: reduced capacity to consent in an altered state, trauma histories involving touch, and any touch that could be sexualised. When unsure, use words, not touch. [synthesis]

4.13 Responding to distress and emergencies (facilitator; centre)

Purpose / when: when a client becomes uncomfortable or distressed, or a medical or behavioural emergency occurs. [source: Scope of Practice fact sheet; Health and Safety fact sheet]
Steps:
1. Stay present and use non-directive reassurance. Facilitators are trained to support distressed clients. [source: Health and Safety fact sheet]
2. Follow the centre's emergency plan, which was reviewed with the client in preparation. [source: OAR 333-333-5000]
3. For any medical or behavioural emergency, contact emergency services, document the event and notify OPS. Medical assessment and treatment are the responsibility of emergency medical staff. [source: Health and Safety fact sheet]
4. Use the emergency contact the client named. The client is responsible for the cost of emergency services. [source: OAR 333-333-5040]
5. Record any adverse behavioural or medical reaction, including severe reactions, on the OHA Client Adverse Reaction form. [source: OAR 333-333-5100; OPS facilitator page]
Example language (illustrative): "This is really hard right now, and it will pass. I'm staying with you. Can you feel your feet on the floor?"
Watch for: chest pain, breathing difficulty, injury, self-harm behaviour, or attempts to leave in an unsafe state. Each is a reason for emergency contact under the plan. [synthesis on the specific triggers]

4.14 Group administration sessions (facilitator)

Purpose / when: when clients choose a group format, such as friends, communities or strangers. Each client gives prior written consent to the group format. [source: OAR 333-333-5000, 5020 and 5230]
Steps:
1. Obtain prior written consent to group participation. Since 2026, meeting other participants beforehand is no longer required. [source: OAR 333-333-5000; Rule Letter November 2025]
2. Keep within the group-size cap (25 clients or the room's occupancy, whichever is smaller) and the minimum client-to-facilitator ratio set by the largest amount any client will consume; the ratio allows fewer clients per facilitator as amounts rise. [source: OAR 333-333-5230; Health and Safety fact sheet]
3. Explain that people may react differently in each other's presence. [source: OAR 333-333-5040]
4. Every client must be present when a group session begins. Each client must be offered the chance to ask for one-to-one support from a facilitator, and a disruptive client is moved, with reasonable efforts, to a separate part of the administration area where others are less affected. In group preparation, clients learn about other clients' possible adverse reactions, boundaries, a consent model for interacting with other clients and touch between clients; outdoor groups may have to stay outdoors whatever an individual prefers. [source: OAR 333-333-5230; OAR 333-333-5020]
5. Get recording consent from every person present (group form). [source: Scope of Practice fact sheet; OPS facilitator page]
Example language (illustrative): "If someone near you is having a loud or hard time, that's theirs. You can ask me for space or a quieter spot."
Watch for: contagion of distress, confidentiality between participants, and social pressure to consume. [synthesis]

4.15 Ending the session and release (facilitator)

Purpose / when: once the minimum duration has passed. [source: OAR 333-333-5250]
Steps:
1. Consult the client about whether to end. End only if both agree that continuing is not needed for the safety of the client and the public. [source: OAR 333-333-5250]
2. Record the end time. Have the client sign the end-of-session release, which confirms they will follow the transportation plan. Use the 2026 Psilocybin Product and End of Session Form. [source: OAR 333-333-5250; OPS facilitator page]
3. Hand the client over to their arranged transport. Record any departure from the plan. [source: OAR 333-333-5100]
4. If the session must run past 11:59 pm, the centre notifies OHA by 4:00 pm the next day. [source: OAR 333-333-5250]
Example language (illustrative): "How are you feeling in your body and mind right now? Do you feel ready to head home with your ride?"
Watch for: a client who wants to leave before they are steady. [synthesis]

4.16 Seventy-two-hour check-in (facilitator)

Purpose / when: within 72 hours after the session ends. [source: OAR 333-333-5250; Health and Safety fact sheet]
Steps:
1. Attempt to contact the client. [source: OAR 333-333-5250]
2. Review the safety and support plan and record any after-effects. Post-session reactions are reported in aggregate to OHA. [source: Health and Safety fact sheet; 2025 redline 4910(6)]
3. Offer information on integration sessions, peer support groups and community resources. [source: OAR 333-333-5250]
4. If the client is in significant distress, activate the safety plan and refer, for example to their therapist, their physician or a crisis line. [synthesis]
Example language (illustrative): "I'm checking in after Saturday. How have the last couple of days been, and is there anything from your support plan you need to use?"
Watch for: sleep loss, persistent anxiety, perceptual disturbances, or suicidal thoughts. Escalate to clinical care. [synthesis]

4.17 Integration sessions (facilitator; dual licensee; outside therapist)

Purpose / when: optional, after administration, to help the client make sense of and apply the experience. [source: Scope of Practice fact sheet; OAR 333-333-5120 for the nondirective approach]
Steps (facilitator without another licence):
1. Review the safety and support plan. [source: Scope of Practice fact sheet]
2. Use a non-directive approach: support the client's own sense-making and avoid giving direct advice or interpretation. The facilitator-conduct rule requires a nondirective approach in preparation, administration and integration sessions. [source: OAR 333-333-5120]
3. Offer resources, referrals or other integration options, such as peer groups. [source: Scope of Practice fact sheet]
Steps (dual licensee, from 1 January 2026):
1. Notify OPS of your licence status and tell the client before providing health or behavioural-health services. [source: Rule Letter November 2025]
2. Provide services within your own board's scope and record-keeping rules. OPS rules do not override the other board's requirements. [source: Rule Letter November 2025]
3. Store OPS client records at the service centre. [source: Scope of Practice fact sheet; OAR 333-333-5100]
Steps (outside psychotherapist):
1. Invite an open account of the experience without imposing a frame. [synthesis]
2. Link insights to existing treatment goals, and work through difficult or ambiguous material with your usual methods (for example processing recovered memories carefully and without suggestion). [synthesis]
3. Help the client choose a small number of concrete behavioural changes, and review them over the following weeks. [synthesis]
4. Screen for adverse after-effects and reassess risk. [synthesis]
Example language (illustrative): "What stands out most when you think back? Is there anything you'd like to do differently because of it?"
Watch for: grandiosity, sudden major life decisions, new spiritual distress, or recovered-memory claims treated as certain. Move slowly. [synthesis]

4.18 Records, confidentiality and data (facilitator; centre)

Purpose / when: throughout. [source: OAR 333-333-5100]
Steps:
1. Keep the following records: the Client Information Form, informed consent, transportation plan, session dates and times, products consumed (identifiers), departures from the plan, adverse reactions, and conditional consents and plans. Store them only at the client's service centre. [source: OAR 333-333-5100; Scope of Practice fact sheet]
2. Disclose nothing without written consent or an ORS 475A.450 exception. Access only the records of your own clients. [source: OAR 333-333-5040; Scope of Practice fact sheet]
3. Collect the SB 303 client data form (2026 version). The client may ask for it to be withheld. [source: OAR 333-333-5000; OPS facilitator page]
4. Centres report adverse reactions to OHA quarterly in aggregate. [source: 2025 redline 4910]
Watch for: creating psychotherapy notes about OPS sessions outside the centre. Dual licensees should check this with their board. [source: Rule Letter November 2025] [synthesis on the risk]

4.19 Liaison between outside psychotherapist and facilitator

Purpose / when: when your client is going through OPS and wants coordinated care. [synthesis]
Steps:
1. Get the client's written authorisation on both sides. OPS has an Authorization to Disclose Personal Identifiable Information form, and you need your own release as well. [source: OPS facilitator page; OAR 333-333-5000] [synthesis on dual releases]
2. With consent, share the risk information relevant to safety planning. The facilitator, not you, makes the eligibility decision. [source: OAR 333-333-5050] [synthesis]
3. Agree how you will be informed of any adverse reaction and who leads post-session support. [synthesis]
4. You may attend administration only as a client support person, usually an observer, and not as a clinician. That needs the client's written consent, the agreement of the facilitator and centre, and a completed Interpreter or Client Support Person Plan. In that role you may do only what the plan lists, may not provide psilocybin services or take part in the session, must follow the facilitator's reasonable directions, and may be asked to leave. A non-facilitator may not practise their licence in that role. [source: Interpreter or Client Support Person Plan form under OAR 333-333-5070; OAR 333-333-5000; Scope of Practice fact sheet] Whether attending is wise, given your therapy role, is a clinical judgement [synthesis].
Watch for: blurred roles, and the client feeling pressure to report to you. [synthesis]

4.20 Harm reduction for clients using outside the programme (outside psychotherapist)

Purpose / when: when a client discloses, or plans, unregulated use outside licensed centres or outside Oregon. This is harm reduction only; it never supports or arranges illegal use. [synthesis]
Steps:
1. Respond without judgement and do not facilitate. Explain that use outside OPS has no legal protection in Oregon and is illegal federally. [source: OAR 333-333-5040 for federal status] [synthesis]
2. Assess risk: psychiatric history (psychosis, bipolar disorder), lithium and other medications in general terms, current suicidality, setting, and whether a sober person will be present. [synthesis, drawing on the OPS exclusions]
3. Give general safety education: interactions are a real risk, so check with a pharmacist or prescriber; untested products may vary unpredictably; do not drive. Offer the regulated route as a safer alternative where the client is eligible. [synthesis; source: OAR 333-333-5040 on potency variability]
4. Make a safety plan and offer integration support afterwards. [synthesis]
5. Document the advice. Follow your licensing board's guidance and your employer's policy. [synthesis]
Example language (illustrative): "I can't help you get or use it, but I can help you think through the risks and be here afterwards."
Watch for: crisis-motivated use, mixing with other substances, and use while on lithium. [synthesis]

5. Handling problems

The OPS sources set rules but give little clinical troubleshooting. Most responses below are therefore [synthesis] and are tied to the rules where possible.

Client is excluded (lithium, current thoughts of harm, active psychosis). The rule bars administration. Say so clearly and without shame. Do not help the client work around it, for example by stopping lithium to qualify. Any change to medication is for the prescriber to decide on clinical grounds alone. Offer evidence-based treatment for the underlying problem. [source: OAR 333-333-5050] [synthesis on response]
Client minimises or withholds history to get access. Facilitators may decline for any reason. As the outside therapist, explain that accurate answers protect the client, and with consent share relevant risk information. If the client goes ahead against your advice, document your advice and keep the door open for integration support. [source: Client Bill of Rights] [synthesis]
Current suicidal ideation or a recent attempt. Current thoughts of harming self or others exclude the client. A past history triggers a recommendation to consult a health provider. Carry out a standard structured suicide risk assessment and safety plan. Discuss lethal-means safety (secure storage or removal) as usual practice. Recommend delay until the client is stable. [source: OAR 333-333-5050] [synthesis]
Bipolar disorder, a family history of psychosis, or severe untreated PTSD. The rule's only psychiatric hard exclusion is active psychosis. Further caution here is clinical judgement: consider recommending against participation or delay, and involve the client's psychiatrist. [synthesis] [uncertain: no OPS criterion beyond what is stated]
Pregnancy or breastfeeding. The facilitator must say that the risks are unknown. Encourage the client to discuss it with an obstetric provider. [source: OAR 333-333-5050]
Medication worries (antidepressants, other psychiatric drugs). Refer the client to a pharmacist or prescriber. Never give tapering advice outside your scope. Under the rules, any medication needed during the session must be self-administered or given by a named support person. [source: OAR 333-333-5050] [synthesis]
Overwhelm or panic during administration. Use non-directive reassurance and grounding, offer agreed touch only, follow the emergency plan, and contact emergency services for medical or behavioural emergencies. Report to OPS afterwards. [source: Health and Safety fact sheet; Scope of Practice fact sheet]
Client wants to leave mid-session. The consent document says leaving is strongly discouraged. The session ends only when the minimum duration has passed and both agree it is safe. If a client insists on leaving unsafely, the facilitator may call emergency services under the transportation and safety provisions. Keep the client company and calm, and avoid physical restraint. [source: OAR 333-333-5040; 5250] [synthesis on restraint]
Client asks the facilitator to interpret or guide ("tell me what this means"). During administration, gently restate the non-directive frame and save meaning-making for integration. [source: Scope of Practice fact sheet] [synthesis on wording]
Difficult after-effects (anxiety, insomnia, low mood, depersonalisation, perceptual changes, recovered memories). Use the 72-hour check-in and the safety plan, then refer to clinical care. In therapy: normalise and stabilise first, process later, and do not treat recovered material as verified fact. Persisting perceptual effects need medical review. [source: OAR 333-333-5040 lists recovered memories among possible effects] [synthesis on management] [uncertain: OPS sources do not list depersonalisation or persisting perceptual effects]
Non-adherence (skipping integration, ignoring the support plan). Integration is optional, so respect that. Agree a minimum check-in, and remind the client of the resources offered. [source: Scope of Practice fact sheet] [synthesis]
Rupture or complaint about a facilitator or centre. Clients may request another facilitator and file a complaint with OHA. Facilitators must report misconduct that harms or endangers a client. If a client discloses sexual or boundary misconduct, support them in reporting to OHA and, where relevant, to the facilitator's other licensing board. Follow mandatory-reporting duties where they apply. [source: OAR 333-333-5040; 4520; Facilitator License fact sheet on OPS investigations and sanctions] [synthesis on support]
Rupture with the outside therapist (the client feels judged for choosing OPS). Name the difference between assessing risk and disapproving, and repair openly. [synthesis]
Group-specific problems (contagion, intrusive participants, confidentiality). Prepare clients for others' reactions and use the space and ratio rules. Offer one-to-one support on request, and move a disruptive client to a separate part of the administration area. [source: OAR 333-333-5020 and 5230; OAR 333-333-5040] [synthesis for the clinical handling]
Unrealistic expectations or spiritual crisis. Revisit the consent statements on uncertain benefit. Attribute spiritual interpretations to the client's own framework, and refer to spiritual care if wanted. [synthesis]
Dual-licence boundary confusion. No other licence may be practised during administration. In preparation and integration, health services are allowed only after notifying OPS and the client, and within your own board's rules. Check record-keeping with your board. [source: Rule Letter November 2025; Scope of Practice fact sheet]
Legal and occupational exposure. Federal illegality may matter for clients in federal jobs, with security clearances, on immigration paths, or in jobs with drug testing. Raise this in pre-referral. [source: OAR 333-333-5040 on federal status] [synthesis on specific exposures]
Cost barriers. Fees must be disclosed in advance. Discuss affordability, and avoid steering the client toward unregulated use. [source: OAR 333-333-5000] [synthesis]
Rules changing. OPS amended its rules in October 2025 (PH 21-2025, in force from 1 January 2026). A notice of proposed rulemaking filed in late August 2026 proposed amendments to 67 rules covering product labelling, training-programme and practicum requirements, continuing education, applications and fees; hearings were held on 15 and 16 September 2026 and comments ran from 1 to 21 September 2026. OHA then decided not to file final rules from that process or adopt the proposed fee increases, and began a new rulemaking on changes unrelated to fees, with rules advisory committee meetings in November 2026 and a planned effective date of 15 January 2027. [source: OHA Psilocybin Administrative Rules page; OPS 2026 Annual Rulemaking, Part One page] Check the OPS facilitator page before advising clients on process. [source: OPS facilitator page; Notice of Proposed Rulemaking, Aug 2026; 333-333 proposed text 9.1.2026]

Sources

Web sources:

[uncertain]: the content of the PH 21-2025 amendments to OAR 333-333-5020, 5120 and 5230 (the Cornell LII texts cited are as amended effective 1 January 2025; 5070 and 5080 were not amended by that order); an official list of local opt-outs; and the outcome of the rulemaking planned for 15 January 2027.

Statutes cited: ORS 475A (Oregon Psilocybin Services Act, Ballot Measure 109, November 2020); SB 303 (2023); HB 2387 (2025, effective 1 January 2026).

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